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Validation of sub-segmental visual scoring for the quantification of ischemic and nonischemic myocardial fibrosis using late gadolinium enhancement MRI.

Publication ,  Journal Article
Fine, NM; Tandon, S; Kim, HW; Shah, DJ; Thompson, T; Drangova, M; White, JA
Published in: J Magn Reson Imaging
December 2013

PURPOSE: To determine the accuracy and reproducibility of late gadolinium enhancement (LGE) MRI scar quantification using visual sub-segmental analysis (VSSA) versus signal threshold-based analysis in ischemic and nonischemic cardiomyopathy. MATERIALS AND METHODS: One-hundred sixty-one patients with abnormal LGE imaging underwent VSSA and signal threshold-based analysis. VSSA was performed using a 68 sub-segmental model. Signal threshold-based analysis was performed using cutoffs of ≥2, ≥3, and ≥5 standard deviations (SD) above the mean signal of normal myocardium. Comparison of VSSA and signal threshold-based analysis was performed by linear regression and Bland Altman plots. RESULTS: Seventy (44%) patients had ischemic scar, 76 (47%) had nonischemic scar, and 15 (9%) had a combined pattern. Correlation coefficients for VSSA versus signal threshold-based analysis at ≥2, ≥3, and ≥5SD thresholds were r = 0.63, r = 0.79, r = 0.81 (P < 0.001) for all patients, r = 0.74, r = 0.81, r = 0.81 (P < 0.001) in those with ischemic scar, and r = 0.46, r = 0.69, r = 0.72 (P < 0.001) in those with nonischemic scar. Bland Altman analysis revealed no significant bias in total scar volume among all patients (-4.3 ± 7.9%), those with ischemic scar (-4.8 ± 7.8%), or those with nonischemic scar (-2.6 ± 7.6%). Intra-observer and inter-observer variability of the VSSA technique was excellent with a mean difference in total percent scar of 0.3% (-8.3-8.9%) and -0.4% (-9.5-8.5%), respectively. CONCLUSION: A VSSA-based model of myocardial scar quantification is accurate and reproducible in ischemic and nonischemic cardiomyopathy.

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Published In

J Magn Reson Imaging

DOI

EISSN

1522-2586

Publication Date

December 2013

Volume

38

Issue

6

Start / End Page

1369 / 1376

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Retrospective Studies
  • Reproducibility of Results
  • Nuclear Medicine & Medical Imaging
  • Myocardium
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Image Interpretation, Computer-Assisted
  • Image Enhancement
 

Citation

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MLA
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Fine, N. M., Tandon, S., Kim, H. W., Shah, D. J., Thompson, T., Drangova, M., & White, J. A. (2013). Validation of sub-segmental visual scoring for the quantification of ischemic and nonischemic myocardial fibrosis using late gadolinium enhancement MRI. J Magn Reson Imaging, 38(6), 1369–1376. https://doi.org/10.1002/jmri.24116
Fine, Nowell M., Shruti Tandon, Han W. Kim, Dipan J. Shah, Terry Thompson, Maria Drangova, and James A. White. “Validation of sub-segmental visual scoring for the quantification of ischemic and nonischemic myocardial fibrosis using late gadolinium enhancement MRI.J Magn Reson Imaging 38, no. 6 (December 2013): 1369–76. https://doi.org/10.1002/jmri.24116.
Fine NM, Tandon S, Kim HW, Shah DJ, Thompson T, Drangova M, et al. Validation of sub-segmental visual scoring for the quantification of ischemic and nonischemic myocardial fibrosis using late gadolinium enhancement MRI. J Magn Reson Imaging. 2013 Dec;38(6):1369–76.
Fine, Nowell M., et al. “Validation of sub-segmental visual scoring for the quantification of ischemic and nonischemic myocardial fibrosis using late gadolinium enhancement MRI.J Magn Reson Imaging, vol. 38, no. 6, Dec. 2013, pp. 1369–76. Pubmed, doi:10.1002/jmri.24116.
Fine NM, Tandon S, Kim HW, Shah DJ, Thompson T, Drangova M, White JA. Validation of sub-segmental visual scoring for the quantification of ischemic and nonischemic myocardial fibrosis using late gadolinium enhancement MRI. J Magn Reson Imaging. 2013 Dec;38(6):1369–1376.
Journal cover image

Published In

J Magn Reson Imaging

DOI

EISSN

1522-2586

Publication Date

December 2013

Volume

38

Issue

6

Start / End Page

1369 / 1376

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Retrospective Studies
  • Reproducibility of Results
  • Nuclear Medicine & Medical Imaging
  • Myocardium
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Image Interpretation, Computer-Assisted
  • Image Enhancement